Enflurane-induced grand mal seizures during otic microsurgery.
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Abnormal electroencephalographic seizure-like activity and myoclonic movements have been recognized during enflurane anesthesia. This is most commonly seen in the presence of respiratory alkalosis and high concentrations of enflurane. Immediate and delayed postoperative generalized tonic-clonic convulsions have also been reported after enflurane anesthesia. Experimental studies have shown that auditory stimuli could facilitate seizure activity during deep enflurane anesthesia. Here we report a case of intraoperative generalized tonic-clonic convulsion during low concentrations of enflurane without evidence of hyperventilation and the presence of auditory stimulation. (+info)
Localization of proliferating cell nuclear antigen in aural cholesteatoma.
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Middle ear cholesteatoma is not a genuine tumor but has a remarkable proliferative activity which causes serious destruction of the mastoid bone. In the present study, we used immunohistochemistry with antiproliferating cell nuclear antigen (PCNA) antibody on cholesteatomatous tissues to evaluate the localization of PCNA, as it has been said that PCNA is a very available protein for showing cell proliferative activity. Moderately concentrated PCNA was demonstrated within the germinal basal layer cells of the cholesteatomatous epithelium in three of eight surgical specimens. Furthermore, in one case of very active osteolytic cholesteatoma, PCNA activity was demonstrated in the mesenchymal cells, probably fibroblast-like cells, in direct contact to the destroying mastoid bone lesions. Although the etiology and histopathology of the invasive and proliferative activity of middle ear cholesteatomatous tissues are unclear, this observation suggests that immunohistopathological examination using PCNA antibody might be a useful tool for evaluating bone resorption activity and for establishing the prognosis of various types of cholesteatoma. (+info)
Bilophila wadsworthia isolates recovered from a right-ear cholesteatoma and brain abscess of the same patient were analyzed by means of polymerase chain reaction (PCR) fingerprinting with single primers (T3B and M13 core) to ascertain if they originated from the same clone. Their PCR fingerprint profiles were compared with those of three additional B. wadsworthia clinical isolates and the type strain (ATCC 49260). The two isolates from the same patient produced PCR fingerprint profiles identical to each other, regardless of which primer was used. All isolates' PCR fingerprint profiles, with use of either the T3B or M13 core primer, shared some major and minor bands. However, differences in additional major and minor bands distinguished each of the additional isolates, suggesting that there are different subgroups of B. wadsworthia. (+info)